9775 SW PEMBROOK STREET �0
9775 SW Pembrook Street
CITYOF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES E ISSU #: ME 1O- 2 �)03(,1
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8'2U!0:?
PARCE' . 2S1 11 RD (0)01)
SITE ADDRESS: 09775 S`JV PEMBROOK ST
SUBDIVISION: CLOUD CAP ZONING. R-3 !,
BLOCK: LOT: 002 JURISDICTION: T!(;
CLASS OF WORK: OTR FLOOR FURN. EVAP COOLERS:
TYPE OF USE: S1 UNIT HEATERS: VENT FANS:
OCCUPANCY GRP. R3 VENTS W/O APPI : VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS:
_FUEL TYPES Y� 0 3 HP: 1 DOMES. INCIN:
3 15 HP: COMML. INCIN-
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYE=RS:
FURN < 100K BTU: 1 AIR HANDLING UNIT_ S OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfn;:
Remarks: Replace furnace and install new a/c
Owner: _ _ FEES __ _
MARK THOMPSON Type By Date Amount YReceipt
9775 SW PFMBROOK PRMT CTR 8/20/02 $72.50 272002000C
TIGARD, OR 97223 5PCT CTR 8/20/02 $5.80 272002000C
Phone:503-620-1846 Total $78.30
Contractor:
COLUMBIA HEATING + COOLING INC
8900 SW BURNHAM
TIGARD, OR 97223 REQUIRED INSPECTIONS_,___.__
Heating Unt Insp
Phone:624-2704 Cooling Unt Insp
Reg #:LIC 76359 Final Inspection
PLM 34-175
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is scjsn,-nriPra
for more than 180 days. ATTENTION: Oregon law requires you to fLllow rules adopted in th3 Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
92-0101-0080. You may obt ih ies of these rules ordirect questions to OUNC by cFIlinc,
n'117aR_U11��1
sue _t jAiL Permittee S gnature
Call (503) 639-4175'by 7:00 P.M. for inspections needed the next business day U
/ L
r
Mechanical Permit Applicati®n
City of Tigard
Datereceived- Permit no.: a City of Tigard Addreft 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no Expiredate:
--
Phone: (503) 639-4171 Date issued: By: Receipt ne.;
Fax: (503) `98-1960 Case file no.: Payment type:
Land use approval: _ Building permit no.:
-- i
TVPE OF PERMIT
U 1 & 2 family dwelling or accessory Commercial/industrial U Multi-family J Tenant improvement
U New construction � Addition/alteration/replacement U Other JOB SITE INFORMATION
t t
Job address: �` 'fhJ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials,equipment,labor, ,verhead,
'T'ax map/tax lot/account no.: profit. Value$
l.ot: Block: Subdivision: - *See checklist for important application information an-_'
Project name: diction's fee schedule for residential permit fee
ty/county. T 46 - -A ZIP: t
I ascription and Iucat[n of work on premises:
_ moi— 'T -=2 �- 1`7.!/�7,vAU
jr
I.,.t.date of completioNinspection: Description Qty. R..onl Res.orO
Tenant improvement or change of use:
Is existing space heated or conditioned?U Yes U NoAir handling unit CFM
Is existinh space insulated't❑Yes ❑ Nu icon tuoning(s
Air
regwred) —'
A terauon Of existing A system
MECHANICAL CONTRACTOR of er compressors
Business nameState boiler permit no..
Tens 13TUM I
Address: ai V-X 3 031 HP Fire/smokedampers/duct smoke detectors
City: State: ZIP; eat pump(site p an required) --
Phone: ix _ E-mail: nsta rep ace urnac urner v—# I/ -- -`
-- Including ductwork/vent litter U Yes)No
CCB no.: '�` 3 S�- nsta /rep ace reTo`caleheaters-suspended,
City!mctiu lie, nu 1 ? ---�— w�ggermxucin:
ormounted
--- - -
Name(.please print '7,'e A o t ! Alo/j c-�clL. fp iance other than furnace _-
tPERSON
n Absorption units BTU/H _
Name: �,�w� p1 � Chillers HP _-
Address: C'nm uessors___ HP
---- ri ronmenta exhaust an ventilation: I
City: _ T State. ZIP:_
__ AI>plrance,ent
Phone .210,1 Fax. gg6 Email. Dryerexhaust _
Hoods,TypeM
11 res itcheNhazrnat
hood fire suppression system
Narne: �� -�� 7-7i4d A-AL _ Exhaust fan with sin le duct(ball fans)
Mailing address: 7 ) x laust system Mart from heating or A
City ue piping andistribution(up to outlets)
" � n"+oL State: ZIP:
-- - lypc: LTG NG UII
Phone: holy Fax &mail: Fuel ):pin g each additional over outlets
rocesspiping(schematic required
Name: Number of outlets
-Other t appliance or equipment:Address: Go:-rative fireplace
City: State: ZIP: Insen-ty a _- -
f Phone: Fax: E-mail: Woo sto•:e/pe:letsto• .e -
Applicant's signature. Date: -? : t
--other
-
Applicant's ter:
":ante (print.. 4)e. / _ —
NW ail)unsclicuau wctpi credit cods,pleats call)wisdiction for more information Permit fee...................- .SG
Notice:This permit application
Viso u MasrRrcard Minimum fee......... .. ...$ _—
expires if a permit is not obtained
Credit can)nimbi --- Expires within Igo days after it has been Plat review(at 9F) $
State surcharge(8%) ....$
Nurse or cardhot r u shown on cr�ii cud $ accepted as complete. TOTAL . $
C:udh01 rail — Amaw
440461'r6FA+Cpk1
Columbia Heating, & Cooling, Inc.
P.O, Box 2.30397
Tigard, OR 97223-0.397
Phone: 90.1-624-270.4
Fax: 503-598-0270
g'7 ,Sw F'EM6R DAK
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST —
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received — --Date Requested AM ----- PM— BUP
Location __ _ --Suite_ MEC J 0 �
Contact Person _ – Ph(— ) d PLM
Contractcr _ —_—_._ Ph(—_—) —.. SWR
BUILDING Tenant/Owner _____ _ ELC _
Footing ELC _--- —_
Foundation Access:
Ftg Drain ELR -----
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam _- —___._ --------- _
Shear Anchors -
Ext Sheath/Shear --- -------- - -
Int Sheath/Shear
Framing -----
Insulation
Drywall Nailing ---- ---- - ------- -- --- -- �- --- - --
Firewall
Fire Sprinkler ------ ---- --- - - - - -.--------- - —- ----- ---
Fire Alarm
Susp'd Ceiling -- - ---- --
Roof ---- -- ----
Other:- -- -- - - -- ----... -
Final - ------ ---- - ..
PASS PART FAIL_
PLUMBING _ -- - - -- - - ---
Post S Beam —
Under Slab --- - _ ------ - - ---
Rough-In
Water Service --�
Sanitary Sewer
Rain Drains ---- --
Catch Basin/Manhole
Storm Drain -- —
Shower Pan
Other: -
Final _—
PASS PART FAIL - -
MECHANICAL ---
Post&Beam
Rough-In --- - -- —
Gas Line
Smoke Dampers -----
-ffi1�1
Acs PART FAIL - ------------ _�
_TRICAL-- - —_— _— -
Service
Rough-In ----- ------ - - -- - -
UG/Slab
Low Voltage -— - - -- - - ------ ---_ -__— —
Fire Alarm
Final
_PART FAIL Reinspection fee of$_ --_required be:ore next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS
SITE - [� Please call for reinspection RE:_---.--.- -._ Unsible to inspect-no access
Fire Supply Line
ADA Approach/Sidewalk Data ` Inspactow J _ --- EXt
--- -
Other:
Final DG NOT REMOVE this inspection record from .he job site.
PASS PART FAIL